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Utu Sili
Abstrak :
Ruang Lingkup dan Cara penelitian : Dalam melaksanakan pekerjaan fisik yang baik diperlukan fungsi paru yang baik. Pengetahuan tentang faktor - faktor yang mempengaruhi fungsi paru dapat dimanfaatkan untuk perencanaan langkah-langkah upaya pencegahan. Telah dilakukan suatu studi Kros - Seksional di tambang emas Pongkor untuk mengetahui prevalensi gangguan fungsi paru dan diketahui ada tidaknya hubungan fungsi paru dengan faktor umur, lama kerja, tempat kerja, kebiasaan merokok dan pemakaian alat pelindung diri, masker. Sampel penelitian adalah seluruh pekerja yang memenuhi kriteria persyaratan sampel penelitian, dan berjumlah 132 orang. Hasil dan kesimpulan : Fungsi paru pekerja tambang emas di Pongkor adalah sebagai berikut : Penurunan KVP ( kasus reetriktif ) 16 orang (12,1 %), penurunan VEP1/KVP ( kasus obstruktif ) 2 orang ( 1,5 % ), keluhan saluran pernafasan 28 orang ( 21,2 % ), kelainan pemeriksaan fisik 36 orang ( 27,3 % ) dan kelainan pemeriksaan radiologik 7 orang {14%). Faktor yang mempengaruhi penurunan KVP secara bermakna adalah pemakaian alat pelindung diri masker ( p < 0,05 ), sedangkan faktor umur, lama kerja, tempat kerja dan kebiasaan merokok tidak berpengaruh secara bermakna. ......SCOPE AND METHOD OF STUDY : A Cross - Sectional study was conducted on gold mining workers at Pongkor. The aim of the study was to assess lung functions and the influencing factors : age, duration of work, place of work, smoking habits and using protective masks. One hundred and thirty two respondents from a total of 300 workers met the criteria for the study. RESULTS AND CONCLUSION : The results showed that the prevalence of decrease in FVC was 12,1 %, decrease of FEV1/FVC was 1,5 %, respiratory symptoms was 21,2 %, abnormal finding of pulmonary examinations was 27,3 % and radiological abnormality was found in 7 out of 50 respondents. The use of protective masks had significant influence on the prevention of the decrease in lung function ( p < 0,05 ).
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 1996
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Katili, Amalia K.M.
Abstrak :
Masalah TB adalah masalah kesehatan masyarakat yang merebak keseluruh dunia sehingga WHO mencanangkannya sebagai "global emergency" tahun 1993. Ini meliputi Indonesia yang menempati peringkat ke tiga sedunia. Di Rumah sakit Cibinong terdapat masalah yang berkaitan dengan TB yakni lemahnya kemampuan ketajaman diagnostik pelayanan medis, lemahnya sistem informasi medis yang berkaitan dengan sifat epidemiologis, tampilan klinis dan aspek sosial ekonomi TB, bersamaan dengan keharusan rumah sakit mengembangkan fungsi pelayanan rujukan dan pembinaan institusi lain di wilayah cakupan RS. Selain itu juga terdapat perbedaan dan variasi penanganan antar spesialisasi yang terkait dengan TB. Dan hal tersebut diatas diperlukan upaya komprehensif dan terkoordinasi berupa pengorganisasian penanggulangan TB yang berdasarkan komitmen internal rumah sakit dan ditindaklanjuti dengan penetapan misi dan tujuan serta penetapan struktur dan rancangan organisasi. Penelitian tentang upaya pengorganisasian ini adalah penelitian partisipatif kualitatif untuk memperoleh pemikiran, pendapat dan pandangan para pelaku organisasi RSUD Cibinong terhadap pembentukan organisasi penanggulangan TB. Seluruh informasi dan data dikelompokkan dan dianalisis secara deskriptif atas pola-pola yang meliputi pemrosesan satuan, tema dan kategorisasi serta penafsiran data yang memunculkan rumusan kesimpulan. Hasil yang diperoleh menunjukkan hampir semua jawaban responden memenuhi tema misi dan tujuan pengorganisasian secara umum yang sejalan dengan tujuan jangka pendek nasional penanggulangan TB. Tujuan khusus menggambarkan komitmen internal menjadikan rumah sakit Cibinong adalah rumah sakit rujukan untuk kasus TB dan puskesmas di wilayah Bogor. Strategi dasar adalah upaya terpadu dan komrehensif disertai pendidikan dan penyuluhan internal rumah sakit. Rancangan struktur organisasi P2TB didasarkan pada produk yakni manajemen kasus TB, berdasarkan suatu proses yang memungkinkan pengembangan derajat keahlian yang lebih baik dengan penekanan pada output. Rancangan juga berdasarkan orientasi pada masalah pasien yang lebih spesifik yakni tipe kasus. Organisasi P2TB berada di dalam wadah Komite Medik, terintegrasi dengan komponen Komite Medik yang lain. Model organisasi divisualisasikan melalui dokumen yang terdiri dari penjabaran misi dan tujuuan, administrasi dan pengelolaan, staff dan pimpinan, fasilitas dan peralatan, kebijakan dan prosedur, pengembangan staf dan pendidikan serta evaluasi dan pengendalian mutu. Saran yang diajukan adalah SMF Paru diharapkan dapat memberi masukan yakni pendapat dan pengarahan dalam perencanaan tujuan, prosedur operasional dan cara terbaik melaksanakan suatu keputusan berbagai masalah penanggulangan yang menghubungkan kerjasama rawat berbasis klinis pada organisasi rumah sakit dengan yang berbasis kesehatan masyarakat di puskesmas dalam wilayah cakupan RS. ......Development of TB Care Organization in Cibinong District Hospital Tuberculosis (TB) is a community health problem that spread over the world so WHO put its condition as "global emergency" in 1993. This part's included Indonesia that rose the third grade of the world. Cibinong Hospital believes that many problems of ineffective global action, which relates to TB endemic. They are representing a diagnostic sharpness of medical service ability, the weakness of medical information system and report's registration that have to do with epidemiological-clinical appearance and TB's social economic aspect, along with the obligation to construct improving the referral and educational function in hospital's area. Beside that, there are also differences and various ways to handle, among parts of specialization connected to TB. From several things above. we need a comprehensive and coordinated exert that appear as TB's preventive organizing based on hospital's internal commitment and continue with mission, purpose confirmation and organizational structure and design. This participatory qualitative research's constructed to get several opinion, thinking and vision of organization's staff of Cibinong Hospital to create TB care and preventive organization. All information and data's being grouped and analyzed descriptively in patterns containing unity, theme, categorization and interpretation resulting of conclusion. The results show that almost all respondents' answers granted the general organizing missions and purposes, along with National short time purposes of TB prevention. The particular is the drawing of internal commitment makes Cibinong Hospital becomes referral center for TB cases and public health facility in Bogor area. The basic strategies are coordinated and comprehensive expedients along with internal hospital's education and instruction. The structural design of TB care organizations based on product. That's the management of TB cases, constructed on a process that allows the improvisation of a better ability, forced on outcome. The design also based on orientation inside more specific patient's problem, the type of case. TB care and prevention organization is inside the medical committee, integrated with other component. The types of organization's being visualized by document consist of explanation such factors as missions and purposes, administrations and management, staff and leader, facilities and instruments, ability and action, staff improvement and education also evaluation and quality control. It was suggested to conduct another continuing research on the developing of collaborative care organization for all of case management. We hope pulmonary staff medical becomes a director in planning, operational procedure and to make a decision in any kinds of TB prevention problem that contain of clinical-base collaborative care on hospital organization with the ones that based on community health in hospital's area.
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2001
T3740
UI - Tesis Membership  Universitas Indonesia Library
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Sulastri
Abstrak :
Petugas kamar bedah merupakan salah satu jenis tenaga kesehatan yang mempunyai resiko tinggi terhadap kemungkinan terpapar oleh berbagai kuman penyakit, terutama HIV/AIDS yang saat ini sangat ditakuti. Salah satu upaya perlindungan diri adalah dengan menerapkan kewaspadaan universal melalui tindakan cuci tangan secara benar, penggunaan alat pelindung, desinfektan, mencegah tusukan alat/benda tajam. Adapun konsep yang dianut adalah, bahwa semua darah dan cairan tubuh tertentu harus dikelola sebagai sumber yang dapat menularkan HIV, Hepatitis dan berbagai penyakit lain melalui darah. Departemen Kesehatan telah menetapkan upaya peningkatan mutu layanan kesehatan dengan memprioritaskan upaya pengendalian infeksi nosokomial bagi seluruh rumah sakit di seluruh Indonesia, antara lain dengan menerapkan kewaspadaan universal. Sejalan dengan ketetapan Departemen Kesehatan tersebut, maka Rumah Sakit Umum Pusat Persahabatan berupaya meningkatkan mutu layanan antara lain dengan upaya pengendalian infeksi nosokomial, salah satu upaya yaitu dengan menerapkan kewaspadaan universal secara baik dan benar di seluruh ruang termasuk kamar bedah. Penelitian ini bertujuan untuk mengetahui tingkat kepatuhan petugas kamar bedah dalam menerapkan kewaspadaan universal dan untuk mengetahui seberapa jauh faktor predisposisi, faktor pemungkin, dan faktor penguat berpengaruh terhadap kepatuhan. Responden adalah seluruh petugas kamar bedah (IGD dan IBS) berjumlah 78, yang terdiri dari dokter dan perawat yang bersifat tenaga tetap, berhubungan langsung dalam penanganan pasien, dan telah bekerja minimal 1 (satu) bulan. Metoda penelitian menggunakan rancangan kros seksional. Data diperoleh melalui penyebaran kuesioner dan pengamatan langsung di rumah sakit. Pengumpulan data dilakukan selama periode Maret sampai Mei 2001 (satu bulan lima belas hari) di Rumah Sakit Umum Pusat Persahabatan. Hasil penelitian menunjukkan, bahwa sebagian besar (73,1%) responden memiliki tingkat kepatuhan sedang. Ketidak patuhan lebih banyak ditemukan di IGD dibandingkan dengan IBS, terutama dalam hal tidak mencuci tangan saat datang di kamar bedah (9,5%), saat meninggalkan kamar bedah (15,4%), sebelum melakukan tindakan (12,8%), setelah melakukan tindakan (7,7%), tidak menggunakan alas kaki (12,8%), masih melakukan pemasangan kembali tutup jarum suntik (recapping =87,1%). Pengetahuan responden tentang kewaspadaan universal. sebagian besar masih kurang (73,1) dengan nilai rata-rata 65,995 (p-wald = 0,0448 OR 1,7744). Hasil analisis ditemukan ada hubungan antara variabel pengetahuan, tempat kerja, dan lama kerja di kamar bedah dengan kepatuhan dalam menerapkan kewaspadaan universal. Pengetahuan dan lama kerja merupakan variabel yang paling menentukan kepatuhan dalam menerapkan kewaspadaan universal. Responden yang memiliki pengetahuan kurang berpeluang untuk tidak patuh hampir 2 kali dibandingkan yang memiliki pengetahuan baik setelah variabel lama dan tempat kerja dikendalikan. Berdasarkan hasil penelitian tersebut peneliti menyarankan agar dilakukan upaya meningkatkan pengetahuan petugas melalui sosialisasi kewaspadaan universal dengan pelatihan, penyebaran leaflet, atau mengadakan pekan kewaspadaan universal. Di samping itu mungkin perlu diadakan evaluasi terhadap kcpatuhan secara berkala, bila memungkinkan adakan reward dan punishment. Untuk menjaga kesehatan petugas agar tetap terpelihara sesuai standar kesehatan yang dibutuhkan, perlu adanya pemeriksaan kesehatan secara berkala bagi seluruh petugas kamar bedah.
Factors Related to Obedience Level of Surgery Room Staff in Applying Universal Precautions on Persababatan General HospitalStaff on surgery room is one of health personal who has high risk to possibly contaminate by any of germ disease, especially the frightening HIV/AIDS. One effort of self protection is applying universal precautions through real action such as washing hands properly, using protection tools, disinfectants, prevented any stab from sharp-pointed tools. The adherent concept is all blood and particular body liquid has to be managed as a source, with can infect HIV, hepatitis and other disease through blood. Department of Health has determined effort to increase health service quality with prioritizing effort of restrained nosocomial infection for all hospital in Indonesia, like applying universal precautions. Along with department of Health's determination, Persahabatan General Hospital tries to increase service quality on restraining nosocomial infection with applying universal precaution properly in all room including surgery room. The objective of this research is to understand the obedience level of surgery room's staff in applying universal precautions and to understand how far predisposition factors, enabling factors, and reinforcement factors is influencing the obedience. The cross sectional design is used for research method. Data was obtained by distributing questionnaires and direct observation in the hospital. Data was collected during March to May 2001 (one month and 15 days) on Persahabatan General Hospital. The result indicated that most of respondent (73, 1%) has medium level of obedience. The obedient staff was found on not washing their hands when they arrived at surgery room (9, 5%), when they left surgery room (15, 4%), before they did actions (12, 8%), after they did action (7, 7%), not using fear footwear (12, 8%), still recapped the injection needle (90, 8%). Most respondent have less knowledge on Universal Precautions (73, 1%), mean 65,995. Statistical analyst result indicated that p-wald =0, 0448 OR 1,7744 wich means that there is a meaningful relations between knowledge with obedience level. Respondent who has less knowledge is likelihood to be disobedient more than twice if compare to those who has better knowledge after controlling old working variable. Based on those result, research recommend doing more effort in increasing knowledge of staff through socializing the universal precautions with training, leaflet or Universal Precautions week. The obedience level should be evaluated periodically, present reward and punishment if possible. Health examination has to be done periodically to all surgery room staff.
Depok: Universitas Indonesia, 2001
T8421
UI - Tesis Membership  Universitas Indonesia Library
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Kamaluddin Latief
Abstrak :
Avian influenza pertama kali menyerang manusia dilaporkan di Hong Kong pada tahun 1997. di Indonesia, penyakit ini pertamakali ditemukantezjadi pada unggas di Pekalongan dan Tangerang pada Agustus 2003, dan kasus pada manusia pertama di Indonesia teljadi di bulan Juli 2005 di Kabupaten Tangerang. Berdasarkan laporan Departemen Kesehatanke WHO, sampai tanggal 31 Januari 2008 tercacat ada 124 kasus confirmed avian influenza dan I 01 kematian akibat avian influenza, atau sekitar 35% kasus dari total kasus di dunia dan 45% dari total kematian akibat avian influenza di dunia. Angka ini adalah angka tertinggi di dunia. Daritotal kasus yang ada di Indonesia, 67,7% kasus berada di DKI Jakarta, Jawa Barat dan Banten. Selama ini yang dianggap deterrninan terjadinya avian influenza adalah kontak dengan unggas atau perilaku kondisi tertentu yang berhubungan dengan unggas, namun temuan ilmiah yang menunjukkan hal tersebut masih sangat terbatas. Penelitian ini bertujuan untuk mengetahui deterrninan yang berhubungan dengan kejadian avian influenza di wilayah DKI Jakarta, Jawa Barat dan Banten. Jenis penelitian ini adalah analitik dengan menggunakan metode kasus kontrol. Data primer dikumpulkan dengan melakukan wawancara terhadap responden. Sedangkan data sekunder diambil dari Depkes/DinasKesehatan Propinsil Dinas Kesehatan Propinsi Kahupaten di mana terdapat kasus avian influenza. Sampel seluruhnya berjumlah 201 orang dengan perhandingan kasus dengan kontrol adalah 1:2. Analisis data dilakukan dengan menggunakan uji multiplelogistic regression. Hasil analisis diperolehhubunganyang signifikanantaraumurdengankejadianavianinfluenza setelah dikontrol kontak dengan unggas dan pekerjaan, nilaip value 0.000, OR 20.117, 95% CI 7.731-52.345. Variabel kontak dengan unggas juga berhubungan dengankejadian avian influenza, p value 0.014, OR 9.060, 95% CI 1.571-52.249, setelah dikontrololeh umur dan pekeijaan. Variabel pekerjaan juga berhubungan dengan kejadian avian influenza, pvalue 0.041, OR 3.818, 95% CI 1.059-13.767, setelah dikontrol umur dan kontak dengan unggas. Dari penelitian ini disarankan perlunya rancangan program pencegahan avian influenza dalam bentuk peraturan daerah (perda) yang implementatif dan secara jelas mengatur keterlibatan berbagai sektor, Pengawasan yang ketal terhadap sistem peternakan dimasyarakat dan mengintensifkan pelaksanaan vaksinasi terutama pada peternakan sektor4, adanya penelitian lanjutan, perlunya peningkatan pengetahuan tentang avian influenza di masyarakat dan penerapkan pola peternakan dan lingkungan yang sehat. ......The first documentedavian influenza cases in humans originatedin Hong Kong in 1997. In Indonesia, avian influenza cases for the first time documented inpoultryin Pekalongan and Tangerang in August 2003, and in humans cases on July 2005 in Tangerang district Based on reported of Ministry of Health to WHO until on 31 Januari 2008, there were 124 conflrnled avian influenza cases and I 01 died because of avian influenza, or around 35% and 45% cases in the world died because of avian influenza, This is the higher number in the world. Cases total in Indonesia,67.7%casesarein DKI Jakarta,Jawa Barat and Banten province. During a day, contact with poultry is assumed as determinant of avian influenza disease, however study about this condition is very limited. The purpose of study is to understand about determinant of avian influenza disease in DKI Jakarta, Jawa Barat and Banten province, 2006-2008. Study desain is analysis with case control method. Primary data was collected by interview respondent. Secondary data taken by Ministry of Health Health Service Province/Health Service District where reported avian influenza cases. The total sample were 201 responden with comparison among case and control is I :2. Data analysis using multiple logistic regression analysis. Results study finding association between an age and avian influenza disease after controled by contact with poultry andoccupation, pvalue0.000, OR20.117, 95%CI7.731-52.345. Contact with poultry variabe1 also related with avian influenza disease, p value 0.014, OR 9.060, 95% CI 1.571-52.249, after contro1ed by an age and occupation. Occupation variabe1 also related with avian influenza disease, p value 0.041, OR 3.818, 95% CI 1.059-13.767, after controled by an age and contact with poultry. This research recomended to government to make rule (in order to protect community from disease), quality control of backyard, other research in the future and improvement of community knowledge about health environment.
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2008
T11512
UI - Tesis Open  Universitas Indonesia Library
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Astuti Yuni Nursasi
Abstrak :
[Pengendalian TB paru di Kota Depok masih berorientasi pada pelaksanaan program pengendalian TB nasional, belum terintegrasi dengan pelaksanaan Perawatan Kesehatan Masyarakat sehingga klien TB belum mandiri melakukan perawatan TB. Model P2K3 dikembangkan berdasarkan integrasi model perawatan diri, model perawatan berbasis komunitas dan pendekatan perawatan yang berpusat pada klien. Penelitian ini bertujuan untuk mengetahui efektivitas model pemberdayaan perawat, kader, keluarga dan klien (P2K3) terhadap tingkat kemandirian klien dalam perawatan TB Paru, menggunakan desain kuasi eksperimen pre-post test pada dua kelompok. Penelitian dilakukan di 15 wilayah kerja Puskesmas di Kota Depok dengan kasus TB tertinggi. Penelitian terdiri dari tahap pengembangan model dan pengujian efektivitas model. Sampel diambil secara purposif sebanyak 108, terdiri dari 54 kelompok kontrol dan 54 kelompok intervensi. Hasil menunjukkan model P2K3 efektif untuk meningkatkan kemandirian klien TB Paru sebesar 40,2%. Penerapan model ini perlu didukung dengan kebijakan pelayanan kesehatan dari Dinas Kesehatan. Model P2K3 dan modulnya direkomendasikan digunakan oleh perawat di komunitas sebagai acuan pemberdayaan kader, keluarga dan klien TB Paru; ...... Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients? self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients? self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model?s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients? level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients;Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients;Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients, Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients]
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2015
D2005
UI - Disertasi Membership  Universitas Indonesia Library